Emails, Anat Kelman Shaw, communications director; Patrick Bresette, executive director, Children’s Defense Fund-Texas, May 5-7, 2015

From: Selby, Gardner (CMG-Austin)

Sent: Thursday, April 30, 2015 3:57 PM

To: Anat Kelman Shaw; Children’s Defense Fund Texas

Subject: Inquiry for a possible fact check

Good afternoon.

For a possible fact check, could you provide factual backup information for a claim in the CDF press release?

Here it is: “In the last 24 months, ten rural Texas hospitals have been forced to shut their doors because state leaders have chosen not to invest in our state’s health care systems by rejecting billions in available Medicaid funds to cover more of our state’s uninsured.”

??

W. Gardner Selby

Reporter / News

Austin American-Statesman

PolitiFact Texas

o 512.445.3644

e wgselby@statesman.com

Twitter: gardnerselby and http://www.twitter.com/politifacttexas

Facebook: PolitiFactTexas

statesman.com   austin360.com   ahorasi.com

From: Anat Kelman Shaw [mailto:AKelman@childrensdefense.org]

Sent: Tuesday, April 28, 2015 11:55 AM

To: Children’s Defense Fund Texas

Subject: Children's Defense Fund-Texas Statement on Proposed Tax Cuts Being Debated Right Now in the Texas House

Importance: High

For Immediate Release

April 28, 2015

Contact

Anat Kelman Shaw, Director of Communications

713-664-4080

Children’s Defense Fund-Texas Statement on Proposed Tax Cuts Being Debated Right Now in the Texas House

Austin, TX – Today, the Texas House of Representatives is debating HB 31 & HB 32 — nearly $5 billion in sales and business tax cuts, 40 percent of which would benefit the highest-paid one-fifth of Texans, according to recent legislative analysis. The cuts have been put forward by Republican state representative and Chairman of the House Ways and Means Committee Dennis Bonnen as part of a package of bills that together with tax cuts proposed by the Senate, are the biggest tax cuts considered in nearly ten years.

In response, Children’s Defense Fund-Texas executive director Patrick Bresette issued the following statement:

“The tax breaks being considered today are irresponsible and shortsighted. Instead of offering Texas families pocket change and political rhetoric our elected leaders should be shoring up the foundation of our state’s future – its children.

“It is unacceptable that Texas still ranks among the bottom ten states in overall child-wellbeing and in state spending per resident, two indicators that are directly connected in that ‘you get what you don’t pay for.’ If you do the math, our top leaders appear to be more interested in prioritizing tax breaks for the wealthiest Texans and corporations than investing in the health and wellbeing of our children and families.

“We are further distressed that the House is considering such deep reductions to its revenue stream while our state is standing on the brink of a health care crisis. In the last 24 months, ten rural Texas hospitals have been forced to shut their doors because state leaders have chosen not to invest in our state’s health care systems by rejecting billions in available Medicaid funds to cover more of our state’s uninsured.

“The tax cuts being discussed today are a solution in search of a problem. Texas already ranks in the bottom ten states in overall taxes paid by its people and businesses. Texas doesn’t need to lower taxes, we need wise investments in our future, and that future demands that we invest in children and families.”

###

From: Anat Kelman Shaw

Sent: Thursday, April 30, 2015 7:02 PM

To: Selby, Gardner (CMG-Austin)

Subject: RE: Inquiry for a possible fact check

Good afternoon,

Specific references to 10 hospital closures in 24 months:

1.        http://tribtalk.org/2015/04/22/texas-knows-how-to-solve-health-care-problems/

2.        http://www.texastribune.org/2015/03/20/rural-hospitals-struggle-keep-their-doors-open/

3.    http://lubbockonline.com/local-news/2015-03-21/area-rep-says-lawmakers-have-awareness-rural-hospitals-critical-needs#.VQ9c42TF9qY%20%E2%80%A6

4.    http://texaswellandhealthy.org/2015/04/15/texas-hospitals-closing-patients-suffering-as-legislature-rejects-federal-funds/

(Note: This page cites a few of the articles listed above.)

Additional support:

5.    http://www.torchnet.org/newsroom/?p=1001

6.        http://www.grahamleader.com/ci_27844293/medicaid-expansion-would-have-benefitted-local-hospital

7.        http://breakthroughs.kera.org/rural-hospitals-struggling-in-texas/​

Anat

Anat Kelman Shaw, MPA

Texas Communications Director

Children's Defense Fund–Texas

From: Selby, Gardner (CMG-Austin) [mailto:wgselby@statesman.com]

Sent: Tuesday, May 05, 2015 6:02 PM

To: Anat Kelman Shaw

Cc: Patrick Bresette

Subject: RE: Inquiry for a possible fact check

I have reviewed all the stories you provided. Was Patrick referring to the refusal to expand Medicaid access (per the Obamacare law)?

g.

(Shaw)

1:02 p.m.

May 6, 2015

Good afternoon, Gardner

"How did Children’s Defense Fund learn, or resolve, that the closings occurred due to actions by state leaders. What particular actions?"

“Was Patrick referring to the refusal to expand Medicaid access (per the Obamacare law)?”

More than a million uninsured Texans would qualify for health coverage through expanded Medicaid access (per the Obamacare law). Instead they have been left in a “coverage gap” without affordable options. The large majority (76%) of adults in the coverage gap are in working families.

By willfully refusing to accept federal Medicaid funds to expand coverage to these million or so uninsured Texans, state leaders have had a direct - and negative - fiscal impact on the health care infrastructure of our state. This has been particularly damaging to hospitals who would otherwise see dramatic reductions in the levels of uncompensated care if the state were to accept Medicaid expansion funds.

Several reports and appointed task forces have made clear and compelling recommendations to state leaders that Medicaid Expansion should be pursued. Most of these reports explicitly address the impact on hospitals:

• http://www.coderedtexas.org/files/2015-code-red-report.pdf
• http://www.mhm.org/images/stories/advocacy_and_public_policy/Smart%20Affordable%20and%20Fair_FNL_FULL.pdf
• http://www.houstonchronicle.com/business/medical/article/State-task-force-releases-health-care-report-5998927.php
• http://perrymangroup.com/wp-content/uploads/Medicaid_Expansion.pdf

State leaders have ignored near unanimous support for coverage expansion from the business community, health care systems and other community leaders:

• http://texaswellandhealthy.org/wp-content/uploads/2015/04/Organizations-Supporting-Coverage-Expansion.pdf

Warnings about the negative impact of refusing Medicaid dollars have also come directly from the state's hospital systems (THA, TORCH, individual CEOs, etc.).

National research of the positive impact of Medicaid expansion on hospital systems is readily available:

• http://www.pwc.com/us/en/health-industries/health-research-institute/assets/pdf/pwc-hri-aca-medicaid-expansion.pdf
• http://www.arkhospitals.org/archive/notebookpdf/Notebook_11-03-14.pdf
• http://www.cha.com/documents/press-releases/cha-medicaid-expansion-study-june-2014.aspx
• http://governor.ky.gov/healthierky/Documents/medicaid/Medicaid_Hospital_Report.pdf

Despite all of this, state leaders have:

• Passed an amendment during the 2013 session to SB 7 explicitly prohibiting HHSC from utilizing any new federal matching funds through Medicaid to expand coverage (Amendment 26 by Rep. Leach, adopted onto the bill May 20, 2013.

http://www.legis.state.tx.us/tlodocs/83R/amendments/html/SB00007H226.HTM)

• Held a press conference on March 2nd of this year demanding impermissible changes to Medicaid (http://www.scribd.com/doc/257432038/Lt-Governor-Patrick-State-Senators-Take-a-Stand-Against-Medicaid-Expansion-in-Texas and http://www.texastribune.org/2015/03/02/gop-leaders-say-they-wont-expand-medicaid/) and stating that: “Any expansion of Medicaid in Texas is simply not worth discussing,” state Sen. Charles Schwertner, R-Georgetown, chairman of the Senate Committee on Health and Human Services, said at a press conference.​

• Voted down a Medicaid Expansion amendment in the Senate (offered by Sen. Rodney Ellis during debate on the state budget bill)

• Refused to give several Medicaid Expansion bills a hearing in the House or Senate: http://texaswellandhealthy.org/2015/04/13/84th-texas-legislature-coverage-expansion-bills/

And, as the previous materials we sent make clear, a central factor in the recent closures has been the lack of Medicaid Expansion dollars that were intended to offset other reductions and reduce uncompensated care.

We hope this information is helpful in clarifying our statement.

Sincerely,

Anat

Anat Kelman Shaw, MPA

Texas Communications Director

Children's Defense Fund–Texas

5410 Bellaire Blvd, Suite 203

Bellaire, TX 77401

p  (713) 664-4080   f  (713) 664-1975

e   akelman@childrensdefense.org

www.cdftexas.org

Step Forward for Children

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(Bresette)

3:01 p.m.

May 6, 2015

If I had another crack at the press release I would change “by” to “including” in the statement you flagged:

“In the last 24 months, ten rural Texas hospitals have been forced to shut their doors because state leaders have chosen not to invest in our state’s health care systems by rejecting billions in available Medicaid funds to cover more of our state’s uninsured.”

Lesson learned, like I said, working my way back into the fray.

There are other factors to consider but we take the spokespeople in the articles and our hospital colleagues at their word that not getting the Medicaid funds that were anticipated under the ACA has been a crippling blow.

Part of why we shared so much background is that we are watching this closely nationally (closures are happening in other non-expansion states) and can’t believe we are going to go another session without this being addressed. More hospitals are projected to close and some form of Medicaid expansion would have made an enormous difference.

Patrick

And (just because we’re incurable wonks . . . here’s a Longview article with a list of closures.

And this article which quotes Harris Health CEO George Masi attributing hospital system budget problems to reduction in federal funds that supplement Medicaid coverage. . .

“Masi attributed the budget problems to a reduction of about $65 million in federal funds that supplement Medicaid coverage. The federal government is reducing those funding sources because of the increased money it is making available to states through the Medicaid expansion program. Texas thus far has declined to participate in the program.”

Patrick Bresette

Executive Director

Children's Defense Fund–Texas

From: Selby, Gardner (CMG-Austin) [mailto:wgselby@statesman.com]

Sent: Thursday, May 07, 2015 10:39 AM

To: Anat Kelman Shaw

Subject: RE: I count 11 rural hospitals in 2013-14; which one doesn't belong? Also, no closings in 2015?

Just noticed several of the listed hospitals were owned or had recently been owned by a physician found guilty last summer of Medicare fraud, per this news story: http://watchdogblog.dallasnews.com/2014/07/tx-hospital-chain-owner-is-not-charles-manson-his-attorney-says-jurors-now-deliberating.html/#more-14037

Would it be reasonable/logical to set those hospitals aside from your list of hospitals affected by the state inaction?

g.

(Shaw)

11:36 a.m.

May 7, 2015

Sure, that’s reasonable.

We were relying on numbers we’d seen reported, initially by Texas Tribune and Lubbock Avalanche, later from TORCH.